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Tree-in-bud appearance - endobronchial spreading of pulmonary tuberculosis

Case contributed by Dr Mohammad Taghi Niknejad

Presentation:

Chronic cough and respiratory distress.

Patient Data:

Age: 56
Gender: Male
Race: Caucasian

Cavitary lesion with decreased lung parenchymal volume is seen at right upper lobe . Alveolar opacity is noted at lingula segment of left  upper lobe.  Centrilobular nodules with a linear branching pattern also seen at both lung parenchyma . 

Case Discussion:

Centrilobular nodules with a linear branching pattern are consistent with  tree-in-bud appearance in a patient with endobronchial spreading of post-primary tuberculosis. 

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